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Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model

DOI: 10.4236/oalib.1106035, PP. 1-9

Subject Areas: Biophysics

Keywords: Transtibial Portal, Anterior Cruciate Ligament (ACL), Radial Distortion, Ar-throscopy

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Purpose: To make the positioning of the anterior cruciate ligament (ACL) transplants as precise as possible, it is necessary to better visualize the foot-print. Identifying anatomic sites is complicated by image distortion inherent in arthroscopy. The standard “Outside-In” ACL reconstruction technique involves drilling a tunnel, i.e. an aperture on the surface of the tibia for the purpose of placing the bone-tendon-bone transplant. This operative technique opens another approach to the inside of the knee, through the tibial plateau (Transtibial-TT). The aim of this manuscript is to assess optimal arthroscopic visibility by calculating radial distortion, arthroscopy insertion positions and different knee bending angles. Methods: We used a standard dot array calibration pattern, an arthroscopic imaging system and Sawbones knee models. The standard deviation and relative standard deviation of distances obtained at distortion of the images were calculated. Results: All captured imagines have shown the effect of distortion so called fish-eye view, i.e. the imagines at periphery were more curved and compressed. Conclusion: The least distorted arthroscopic image of the femoral ACL footprint can be obtained when using the TT portal and by bending the knee between 90° and 130°  with a 30°  arthroscope. Also, the best visualization is performed by drilling the tibia under the angle 0°  in the sagittal plane and 23°  in the coronal plane in comparison to the tibial surface.

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Vranjes, M. , Cvejic, Z. , Todorovic, N. , Gojkovic, Z. and Harhaji, V. (2020). Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model. Open Access Library Journal, 7, e6035. doi:


[1]  Aglietti, P., Buzzi, R., Giron, F., Simeone, A.J.V. and Zaccherotti, G. (1997) Arthro-scopic-Assisted Anterior Cruciate Ligament Reconstruction with the Central Third Patellar Tendon. A 5-8-Year Follow-Up. Knee Surgery, Sports Traumatology, Ar-throscopy, 5, 138-144.
[2]  Khalfayan, E.E., Sharkey, P.F., Alexander, A.H., Bruckner, J.D. and Bynum, E.B. (1996) The Rela-tionship between Tunnel Placement and Clinical Results after Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine, 24, 335-341.
[3]  Sommer, C., Friederich, N.F. and Muller, W. (2000) Improperly Placed Anterior Cruciate Ligament Grafts: Correlation between Radiological Parameters and Clinical Results. Knee Surgery, Sports Trau-matology, Arthroscopy, 8, 207-213.
[4]  Bottoni, C.R., Liddell, T.R., Trainor, T.J., Freccero, D.M. and Lindell, K.K. (2008) Postoperative Range of Motion Following Anterior Cruciate Ligament Reconstruction Using Autograft Hamstrings: A Prospective, Randomized Clinical Trial of Early versus Delayed Reconstructions. The American Journal of Sports Medicine, 36, 656-662.
[5]  Harner, C.D., Honkamp, N.J. and Ranawat, A.S. (2008) Anteromedial Portal Technique for Creating the Anterior Cru-ciate Ligament Femoral Tunnel. Arthroscopy, 24, 113-115.
[6]  Jaecker, V., Zapf, T., Naendrup, J.H., Pfeiffer, T., Kanakamedala, A.C., et al. (2017) High Non-Anatomic Tunnel Po-sition Rates in ACL Reconstruction Failure Using Both Transtibial and Anteromedial Tunnel Drilling Techniques. Archives of Orthopaedic and Trauma Surgery, 137, 1293-1299.
[7]  Vaseenon, T., Phisitkul, P., Wolf, B.R., Femino, J.E. and Amendola, A. (2011) Preventing Damage to Arthroscopic Lens during Surgery. Arthroscopy, 27, 404-408.
[8]  Carlsen, A. (1986) A Broken Telescope: A Complication of Arthroscopy. Arthroscopy, 2, 182-183.
[9]  Hoshino, Y., Rothrauff, B., Hensler, D., Fu, F. and Musahl, V. (2016) Arthroscopic Image Distortion Part I: The Effect of Lens and Viewing Angles in a 2-Dimensional in Vitro Model. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 2065-2071.
[10]  Hoshino, Y., Nagamune, K., Yagi, M., Araki, D., Nishimoto, K., et al. (2009) The Effect of Intraoperative Knee Flexion Angle on Determination of Graft Location in the Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction. Knee Surgery, Sports Traumatology, Ar-throscopy, 17, 1052-1060.
[11]  Hoshino, Y., Rothrauff, B.B., Hensler, D., Fu, F.H. and Musahl, V. (2016) Arthroscopic Image Distortion Part II: The Effect of Lens Angle and Portal Location in a 3D Knee Model. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 2072-2078.
[12]  Zantop, T., Haase, A.K., Fu, F.H. and Petersen, W. (2008) Potential Risk of Cartilage Damage in Double Bundle ACL Reconstruction: Impact of Knee Flexion Angle and Portal Location on the Fem-oral PL Bundle Tunnel. Archives of Orthopaedic and Trauma Surgery, 128, 509-513.
[13]  McMillan, S., Saini, S., Alyea, E. and Ford, E. (2017) Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee. Arthroscopy Techniques, 6, 1119-1124.
[14]  Lubowitz, J.H. (2009) Anteromedial Portal Technique for the Anterior Cruciate Ligament Femoral Socket: Pitfalls and Solutions. Arthroscopy, 25, 95-101.
[15]  Bedi, A. and Altchek, D.W. (2009) The “Footprint” Anterior Cruciate Ligament Technique: An Anatomic Approach to Anterior Cruciate Ligament Reconstruction. Arthroscopy, 25, 1128-1138.
[16]  Cho, Y., Cho, J. and Kim, D. (2012) Normal Sagittal of the Anterior Cruciate Ligament Can Be Reproduced Using Accessory Anteromedial Portal Technique: A Magnetic Resonance Imaging Study. Archives of Orthopaedic and Trauma Surgery, 132, 1011-1019.
[17]  Guler, O., Mah?rogullar?, M., Mutlu, S., Cerc?, M.H., Seker, A., et al. (2016) Graft Position in Arthroscopic Anterior Cru-ciate Ligament Reconstruction: Anteromedial versus Transtibial Technique. Archives of Orthopaedic and Trauma Surgery, 136, 1571-1580.
[18]  Brown, D.C. (1971) Close-Range Camera Calibration. Photogrammetric Engineering, 37, 855-866.
[19]  Brown, D.C. (1966) Decentering Distortion of Lenses. Photogrammetric Engineering, 32, 444-462.
[20]  Drap, P. and Lefèvre, J. (2016) An Exact Formula for Calculating In-verse Radial Lens Distortions. Sensors, 16, 807.
[21]  Dougherty, G. (2009) Digital Image Pro-cessing for Medical Applications. Cambridge University Press, New York.
[22]  Hartley, R. and Kang, S.B. (2007) Parameter-Free Radial Distortion Correction with the Center of Distortion Estimation. IEEE Transactions on Pattern Analysis and Machine Intelligence, 29, 1309-1321.
[23]  Asari, K.V., Kumar, S. and Radha-krishnan, D. (1999) A New Approach for Nonlinear Distortion Correction in Endo-scopic Images Based on Least Squares Estimation. IEEE Transactions on Medical Imaging, 18, 345-354.


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